The renovated Cedar/Holly LDRP (labour delivery recovery and postpartum) rooms are open at BC Women’s. Fresh, clean, great glass tiles, most with windows...(ok - avoid Room 18 if you want to sleep - the lovely sunshine streaming through the skylights can be a bit startling in labour.) Now there are close to 30 birthing rooms at this hospital.

However, on any given day, there is still the possibility of being diverted to another hospital. There is either an unexpected baby boom in Vancouver, or too few nurses on shift, or every labouring woman is trying to get into the BC Women’s birthing suite.

I love attending births in all different settings, and I am awed to see how women are affected by their surroundings. It’s interesting how women’s movements differ in each venue. In a hospital setting, I've never seen anyone leap into a squatting position on the edge of a bathtub, tight in her husband’s arms. But on Monday night, at home, THAT particular position worked for my client. Without hesitation or comment, the midwife rolled up her pants and climbed into the draining tub, to support her. A few minutes later, the baby was born with the couple standing together, feet firmly planted on the ground. What power and autonomy!

I have seen autonomy in the hospital, but it takes much more effort from the labouring woman. One woman said to us, “I have to do this on my own. I’ll be in the dark in the bathroom. You can pop in to listen to the baby’s heartbeat - but don’t say a word. I’ll tell you when the baby’s coming.” This was her first birth. How did she have such strength and inner knowledge? She knew that her doctor, husband, nurse and doula were supportive of her decisions, whatever they might be. We all sat on our hands, silent in the room.

One woman who gave birth at Burnaby Hospital said all the staff were incredulous at her wish to birth without intervention or medication. They couldn’t understand why she waited until she was 9cm before arriving at the hospital. “We’ve been waiting 5 hours for you!” But, she wanted to birth on her own terms - and she did, without fuss or complication. Well, there was a bit of excitement when she was escorted up to the birthing floor by firefighters (who just happened to be outside when she arrived), pushing her down corridors on an office chair!

So, new tiles, old tiles, windows or no windows, home or hospital... what matters is that we all need to flow with a labouring woman’s instincts. We need to put the woman’s needs first, be respectful, calm and unobtrusive. She needs to be undisturbed. This is challenging (almost impossible?) in a busy hospital. So, if you’re pregnant, take a while to think about how we can help you to be autonomous and move freely in labour, whatever your setting.

If you can't stay home, and have to go to the hospital... wear an airline eye-mask, have music playing through your headphones, and throw a silk shawl over your head. Then, you just might be on the right track.